Don't expect your doctor to stand up and protest about how the Affordable Care Act is responsible for so many of the health care problems that patients face today. As a physician and a dentist in private practice, we have spent the past five years making the case that the ACA is harming our patients. While we get many varied and complex questions from them, the one question always asked is a simple one, but one with a more complex answer: "Why aren't more doctors speaking out?" The primary reason is fear. Doctors are afraid of their new bosses —...

There is unprecedented demand for physician assistants as insurance payment and the Affordable Care Act encourage a team-based approach to managing the care of patient populations. A snapshot of this trend can be seen in a new report by The Medicus Firm, a national physician recruiter, which said physician assistants (PAs) rose to No. 5 among its top 10 most frequently placed medical care providers in 2014, outstripping several categories of medical doctors. Primary care doctors continue to hold the top three spots with family physicians at No. 1, followed by hospitalist doctors and internists at No. 3. Just a...

One thing I have often pointed out about the Affordable Care Act (ACA alias Obamacare) is that very few doctors participated in the conceptualization of the legislation. The final bill focuses on expanding Americans’ access to health insurance with a total disregard for increasing the supply of medical professionals or facilities for treatment. Some doctors are directing their efforts to educating their patients and the voting public of what they believe the bill is doing to harm patient care.To better learn the effects upon doctors and thus their patients of this new law, I had a conference call with a...

“Obamacare’s shoddy implementation doesn’t even begin to scratch the surface of its great evil,” reported Breitbart late last year, referring to the healthcare rationing that is insidiously hidden within the pages of the evasive law. Perhaps the most alarming criterion of healthcare rationing found in the Affordable Care Act (ACA) is the plan’s death panel language.Democrats vehemently denied that death panels would play a role in the ACA, but the law itself states that doctors will be paid to have discussions with patients about living wills, advance directives, and end-of-life options.Killing patients whose perceived utility is declining is not exclusively...

Next year, doctors and hospitals will no longer get paid according to the fee for services model. They will get a fixed salary according to how well patients do. We will see the equivalent of patient report cards. Personalized care is out, government one-size fits all healthcare is in. The more tests, scans, surgeries that hospitals and doctors do, the less they will make. What could possibly go wrong? It will have a devastating effect on patients’ access to care. Patients who come back for the same problem will be included in the one-time bulk rate. Beginning next year, Medicare,...

The Obama administration on Monday announced an ambitious goal to overhaul the way doctors are paid, tying their fees more closely to the quality of care rather than the quantity. Rather than pay more money to Medicare doctors simply for every procedure they perform, the government will also evaluate whether patients are healthier, among other measures. The goal is for half of all Medicare payments to be handled this way by 2018. Monday’s announcement marks the administration’s biggest effort yet to shape how doctors are compensated across the health-care system. As the country's largest payer of health-care services, Medicare influences...

Hey, are you one of the 9.7 million Americans who have been put onto the Medicaid rolls since 2013 mostly as a result of theAffordable Care Act? Congratulations! But that and $2.75 will get you one ride on the New York City subway. That's because finding a doctor who accepts Medicaid payments – never all that easy to do even before 2013 – is getting harder than ever thanks to a steep drop in reimbursement rates for doctors who treat patients on Medicaid. When I say "steep," I mean it. We're talking an average of 43 percent nationwide and almost...

WASHINGTON — Just as millions of people are gaining insurance through Medicaid, the program is poised to make deep cuts in payments to many doctors, prompting some physicians and consumer advocates to warn that the reductions could make it more difficult for Medicaid patients to obtain care.

Andy Pasternak, a family doctor in Reno, Nev., has seen more than 100 new Medicaid patients this year after the state expanded the insurance program under the Affordable Care Act. But he won’t be taking any new ones after Dec. 31. That’s when the law’s two-year pay raise for primary care doctors like him who see Medicaid patients expires, resulting in fee reductions of 43 percent on average across the country, according to the nonpartisan Urban Institute. The challenge is to convince physicians not just to continue accepting such patients but to take on more without getting paid what they’re...

Kevin McCarthy of Thousand Oaks, California, was surprised last spring, when he learned his family doctor of 14 years could not accept the Blue Shield insurance he'd purchased under Obamacare. He said he was "outraged" because when he was shopping for his policy, Blue Shield confirmed his doctor was covered. "We were duped," McCarthy said. "Hoodwinked is another good term." Here's what happened. Insurance companies -- to save money -- are quietly selling what are called "narrow networks." They sharply restrict the number of doctors and hospitals people can see. In some cases, people may be limited to 30 percent...

An increasing burden of paperwork, tied in part to healthcare reforms driven by Obamacare, now consumes about one-sixth of a typical America physician’s day — impinging on the time doctors can spend caring for patients. That’s the upshot of a new study led by Harvard Medical School researchers who found the average doctor spends 16.6 percent of his or her working hours on non-patient-related paperwork. The findings, which are based on a nationally representative survey of physicians, tied the trend to changes in U.S. health policy — including a shift to employment in large practices, the implementation of electronic medical...

What's the prescription for this man's frustrating, fruitless quest to find a doctor on his Obamacare plan? Going to court. A Yale Law grad is suing a New York insurer, claiming that the $620.69-per-month health plan he bought failed miserably in its promise that its website would be available to help him find a primary care physician "anytime." "Sadly, nothing could be further from the truth," said Jon Fougner's lawsuit against Empire BlueCross BlueShield. Fougner, who filed the case himself, said that after he looked on Empire's site for doctors near him who were accepting new patients, it listed 30...

Californians with health insurance obtained through the Obamacare exchange are continuing to find themselves being turned away when they seek out many top health care specialists and hospitals, according to the latest report in an ongoing investigation by the Los Angeles Times.The Obama Health Care exchange (called Covered California within the state) has the power to exclude insurance plans in the exchange based on rate increases. The problem is the plans often need to raise rates to ensure access to high-level life-saving care. Because plans are worried about being booted from doing business in the state exchanges, they have slashed...

Finding a doctor who takes Obamacare coverage could be just as frustrating for Californians in 2015 as the health-law expansion enters its second year. The state's largest health insurers are sticking with their often-criticized narrow networks of doctors, and in some cases they are cutting the number of physicians even more, according to a Times analysis of company data. And the state's insurance exchange, Covered California, still has no comprehensive directory to help consumers match doctors with health plans. This comes as insurers prepare to enroll hundreds of thousands of new patients this fall and get 1.2 million Californians to...

Obamacare, as its advocates increasingly point out, has succeeded in expanding the number of Americans with insurance. Even though this achievement came at enormous cost, still leaves millions of Americans uninsured, and dumped millions more into Medicaid, this is still one of the few “successes” that the health-care law can claim. However, health insurance and access to health care are not the same thing. And evidence is growing that Obamacare is likely to make it harder for us to see a doctor or otherwise obtain care. Of course, we already know that the limited network of physicians available through most...

Obamacare plans have shrunk payments to physicians so much that some doctors say they won’t be able to afford to accept Obamacare coverage, NPR reports. Many of the eight million sign-ups in Obamacare exchanges nationwide already face more limited choices for physicians and hospitals than those in the private insurance market. But with low physician reimbursement rates, the problem could get even worse. For a typical quick patient visit, Dr. Doug Gerard, a Connecticut internist, told NPR a private insurer would pay $100 while Medicare would pay around $80. But Obamacare plans are more likely to pay closer to $80,...

On a recent afternoon at his office in Hartford, Conn., Dr. Doug Gerard examines a patient complaining of joint pain. Gerard, an internist, checks her out, asks her a few questions about her symptoms and then orders a few tests before sending her on her way. For a typical quick visit like this, Gerard could get reimbursed $100 or more from a private insurer. For the same visit, Medicare pays less — about $80. And now, with the new private plans under the Affordable Care Act, Gerard says he would get something in between, but closer to the lower Medicare...

Obamacare’s emphasis on cost-benefit has apparently granted permission for the medical technocrats to conjure all kinds of healthcare rationing schemes.And the Medical Establishment is apparently playing along. From, “The Cancer Death-Panel App,” by Robert Goldberg in the NY Post: The latest innovation in cancer care isn’t a medical breakthrough but an app to ration new drugs. It’ll measure care in terms of what it costs health plans, instead of what it means for patients’ lives.That it’s being developed under the auspices of the American Society for Clinical Oncology, or ASCO, the world’s leading oncology association, is a grim warning about...

In a recent Politico Magazine article titled, “Let’s Talk About Death Panels,” Harold Pollack urges reviving one of the most notorious proposals that did not make it into the Obama Health Car Law – “advance planning consultations.”During the debate over Obamacare’s enactment, there was considerable controversy over a provision in an early version under which health care providers would have been paid by Medicare to discuss with their patients whether they would want life-saving medical treatment.After former Alaska governor and vice-presidential candidate Sarah Palin dubbed the planning sessions “death panels,” the provision was dropped from the law ultimately enacted.As Pollack...

After being without health insurance for two years, Miranda Childe of Hallandale Beach found a plan she could afford with financial aid from the government using the Affordable Care Act’s exchange. Childe, 60, bought an HMO plan from Humana, one of the nation’s largest health insurance companies, and received a membership card in time for her coverage to kick in on May 1st. But instead of being able to pick a primary care physician to coordinate her healthcare, Childe says she repeatedly ran into closed doors from South Florida doctors who are listed in her plan’s provider network but refused...

A mountainous backlog of Medi-Cal applications is well into its third month, but California officials have provided little information about how and when the largest such bottleneck in the nation might be cleared. Not only has application processing been delayed, the state has also fallen behind in sending final notifications to enrollees, officials confirmed. Meanwhile, many low-income people who qualify for Medi-Cal are showing up at community clinics and costly emergency rooms as they have in the past. Others are putting off care. The holdup in Medi-Cal approvals has led to financial uncertainty for many of California's community health clinics,...

Frustration and legal challenges over the network of doctors and hospitals for Obamacare patients have marred an otherwise successful rollout of the federal healthcare law in California. Limiting the number of medical providers was part of an effort by insurers to hold down premiums. But confusion over the new plans has led to unforeseen medical bills for some patients and prompted a state investigation. More complaints are surfacing as patients start to use their new coverage bought through Covered California, the state's health insurance exchange. "I thought I had done everything right, and it's been awful," said Jean Buchanan, 56....

The right to carry a concealed weapon only exists if your doctor says so. Many states are requiring that physicians certify whether patients are competent to carry a concealed weapon. Some states require mandatory reporting of those deemed not competent to carry a concealed weapon. Of course, the natural extension of such laws is that if the doctors make an inappropriate determination, then the doctors can be held liable if the certifiee does something inappropriate with the weapon.This New England Journal of Medicine article shows that many doctors aren’t comfortable making that determination. Then again, I’ve heard colleagues threaten that...

National insurance giant UnitedHealthcare plans to cut up to 700 Massachusetts doctors from its physician network for seniors enrolled in its private Medicare plan as a way to control costs, according to company officials. For elderly patients enrolled in the plan, the cuts mean they will have to find a new doctor or eventually switch to a new health plan that covers their current doctor. The move, effective Sept. 1, follows similar cuts made by the insurer to its Medicare Advantage provider networks in 11 other states... There is also pending legislation in Congress to prevent health plans from cutting...

This is a re-post of an article I wrote in 2012. I am re-posting it to demonstrate that recent stories about doctor shortages and wait times are absolutely inevitable results of government interventions in the health care economy.My son is in Freshman econ 101, and so I have been posting him some supply and demand curve examples. Here is one for health care. The question at hand: Does government regulation including Obamacare increase access to health care? Certainly it increases access to health care insurance, but does it increase access to actual doctors? We will look at three major...

The federal government may reimburse doctors for talking to Medicare patients and their families about “advance care planning,” including living wills and end-of-life treatment options — potentially rekindling one of the fiercest storms in the Affordable Care Act debate. A similar provision was in an early draft of the federal health care law, but in 2009, former Republican vice-presidential candidate Sarah Palin took to Facebook to accuse President Barack Obama of proposing “death panels” to determine who deserved life-sustaining medical care. Amid an outcry on the right, the provision was stripped from the legislation. Now, quietly, the proposal is headed...

Nick and Rachel Robinson were excited about the possibilities that Obamacare offered them when they found out they were expecting a third child. “It’s one of those times where you hear the news and there’s this immediate sense of joy and excitement like, ‘Yay, a new kid. That’s awesome!’” Nick Robinson told NPR. But the happy news also came with a new set of worries. “What are we going to do? How are we going to pay for this? This is intense.” When the option of the Affordable Care Act became available, the Robinsons believed it was the answer to what they...

LOS ANGELES - A new study finds that just two in five Los Angeles community health clinics are ready for Obamacare, it was reported today. The finding came out of a study by the UCLA Center for Health Policy Research that examined approximately 40 clinics in the Los Angeles area to determine how prepared they were for an expected increase in new patients because of the Affordable Care Act, the Los Angeles Times reported. Under Obamacare, hundreds of thousands of people signed up for health insurance in Los Angeles County, which led the state in sign-ups through Covered California, with...

A California man has been seeking treatment for Lyme disease, something he contracted while on active duty as a Marine, but he’s having a hard time finding a doctor in the San Francisco Bay area that accepts his insurance. The insurance company’s advice? Cancel his plan. KPIX-TV, though, says the fact that he can’t find a doctor within a reasonable distance violates state law and nothing appears to be taking place to fix the issue. The former Marine identified by KPIX by only his first name, Kyle, is covered by Anthem BlueCross through the state exchange Covered California. “I was on the...

When John R. Ammon, M.D. finished his rigorous training at Harvard and Stanford 36 years ago, he swore to uphold the all important Hippocratic Oath – which proclaims – “Do No Harm.” Looking forward to working as an anesthesiologist, he believed he would never have to compromise that solemn promise. Yet, for Dr. Ammon, as for so many hundreds of thousands of physicians, that oath is progressively more difficult to keep. Dr. Ammon has spent a lifetime of serving and healing his patients. More than just participating in a practice, his personal belief systems made him keenly aware of –...

Nearly one-third of California’s total population -- roughly 11.5 million people -- will be enrolled in Medi-Cal next year.. Enrollment is expected to exceed previous estimates by 1.4 million, and administration officials said it would cost the state $1.2 billion more than originally thought.

MIAMI (AP) -- The first thing Michelle Pool did before picking a plan under President Barack Obama's health insurance law was check whether her longtime primary care doctor was covered. Pool, a 60-year-old diabetic who has had back surgery and a hip replacement, purchased the plan only to find that the insurer was mistaken.Pool's $352 a month gold plan through Covered California's exchange was cheaper than what she'd paid under her husband's insurance and seemed like a good deal because of her numerous pre-existing conditions. But after her insurance card came in the mail, the Vista, California resident learned her...

Health insurers are now openly admitting that with Obamacare’s reforms, patient choice can no longer be a priority for Americans. “We have to break people away from the choice habit that everyone has,” Marcus Merz, CEO of Minnesota insurer PreferredOne, told The New York Times Tuesday. “We’re all trying to break away from this fixation on open access and broad networks.” With boatloads of mandatory services provided each and every customer whether they’re wanted or not, health insurers’ costs are going up. If insurance companies are going to keep prices at a manageable level, narrow networks are one of their...

With enrollment in the Obamacare exchanges now closed, Democrats and their friends in the media are ebullient. Obamacare is an enormous success, they say, and conservatives have been humiliated. On closer inspection, however, things seem decidedly less bullish for President Obama’s signature achievement. Among the many exaggerations and inaccuracies the law’s defenders are touting, five stand out. • First, they say that premium rates are down. In support of this, liberals cite research from the Congressional Budget Office (CBO), but they misinterpret it. In fact, the CBO’s most recent estimate of premiums shows a decline not from what they were...

The Affordable Care Act means more and sicker patients are entering hospitals, and less comprehensive and timely health care. As the first enrollees in the Affordable Care Act begin seeking care at my hospital, I wonder how my practice as a Registered Nurse will change. We’re told the goal of the new law is to remodel healthcare in the United States into a system that promotes wellness and prevention, rather than just providing care to sick people. This seems like a great objective, but I worry that the switch may compromise the quality of the care our patients receive.

It's time to defy health-care mandates issued by bureaucrats not in the healing profession. In my 23 years as a practicing physician, I've learned that the only thing that matters is the doctor-patient relationship. How we interact and treat our patients is the practice of medicine. I acknowledge that there is a problem with the rising cost of health care, but there is also a problem when the individual physician in the trenches does not have a voice in the debate and is being told what to do and how to do it. As a group, the nearly 880,000 licensed...

Conservatives have known from the start that the true purposes of the Affordable Care Act (ACA) are: 1.) the eventual implementation of single payer; and 2.) extortion of “acceptable” behavior on the part of the American people in return for life giving, medical care. And the deliberately catastrophic shortcomings created by the authors of ObamaCare have put this fraudulent healthcare scheme right on track to accomplish both. That the Affordable Care Act has little to do with providing healthcare–affordable or otherwise–could not be more obvious. If the intent of politicians was to provide access to medical care for America’s 30...

Sheri Samotin, a California-based patient advocate, knows the ins and outs of health insurance, including how to find a participating physician. But when first navigating the new health insurance options that had sprung from the Affordable Care Act, even she had trouble getting straight answers. Health insurers' provider directories often weren't current, and even doctors' offices were sometimes unsure of what plans they were in. It's just one of the bumps that newly insured Americans and individuals switching health plans may encounter as they try to use their health insurance coverage under Obamacare.

President Obama is doing his victory dance, telling us how his health care plan has become a success because his more than his targeted number (8 million) clicked their desire to have health insurance on a website. We will soon see how many are real policyholders, and later we will see their real costs as everything shakes out with co-pays and renewals next year. What we do know is that Medicaid is a pending disaster waiting to happen. When the Obamacare registration period started we were regularly hearing about all those new Medicaid sign-ups. Then we did not hear about...

She’s reached out to 96 DOCTORS who won’t treat her and it hasn’t changed her mind at all about Obamacare. Wow, you want to talk about “stuck on stupid,” well, this is it. What’s left for conservatives to say to someone who supports a system that puts her through this much other than, “Told you so?”

Medscape, a subsidiary of the medical information website WebMD, has released its 2014 Physician Compensation Report. The data in the report come from more than 24,000 doctors in 25 specialties, who responded to Medscape's annual survey with information on their compensation for 2013.The infographic below shows the average earnings for each surveyed specialty. Orthopedists were the highest earners: In an explanation of their findings, Medscape notes that: "As in the past, those who perform procedures have the highest incomes compared with those who manage chronic illnesses." Some primary care practices saw a slight increase in earnings, "which could reflect early...

While the debate continues over how many ObamaCare enrollees are actually paying their premiums, one aspect of the law temporarily rewards those who actually stop paying – and doctors may wind up bearing the cost. “This law provides a 90-day grace period for people who have subsidized ObamaCare exchange plans and stopped paying their premium," said Betsy McCaughey, health care author and former New York lieutenant governor. But the insurance companies are only obligated to cover the first 30 days of the 90-day grace period

Two months after KPIX 5 ConsumerWatch first reported about some doctors listed on the Covered California exchange were actually not accepting the plans, insurer Anthem Blue Cross admitted that nearly 1,000 doctors were erroneously listed. According to a statement by the California Medical Association, the insurer recently notified 965 physicians that they were wrongly placed on the exchange’s list. The notice, which was posted on April 9th, stated that the doctors were “inadvertently” listed for “a certain period of time” during the open enrollment period.

STATEN ISLAND, N.Y. -- After receiving her new health coverage in January through the New York State of Health Marketplace, Arden Heights resident Margaret Figueroa, 49, who suffers from two chronic illnesses, went to her pharmacy to fill her prescriptions. Although her insurance company, EmblemHealth, assured her she was covered, her insurance card was denied. While she had signed up for new health coverage -- because her insurance carrier dropped her old plan -- the company's internal paperwork apparently wasn't filed. She also learned that all her long-time doctors didn't accept the new insurance plan. For Ms. Figueroa, who suffers...

For years we have known that the claim under Obamacare, “If you like your plan, you can keep your plan,” was false. We have also known that the claim under Obamacare, “If you like your doctor, you can keep your doctor,” was false. But what we didn’t know was that under Obamacare, “If you need a doctor, you may have to drive more than 100 miles to find a doctor.” I noticed in my new Anthem monthly premium under Obamacare that I was required to pay a separate monthly charge for dental insurance for my two teenage children (I also...

Four years after Obamacare became law, the Department of Health and Human Services (HHS) is notifying Medicare providers and suppliers of new fingerprint-based background checks. Eventually, all individuals who hold a five percent or greater stake in a Medicare supplier or provider that is categorized as "high risk" will be subject to the requirement. The provision is part of the Medicare, Medicaid, and CHIP Program Integrity Provisions (Title E) of the Affordable Care Act, and gives the HHS secretary broad discretion in applying the background check requirements depending on the potential for abuse, fraud, and/or waste. The new requirements are...

Nine of 10 doctors discourage others from joining the profession, and 300 physicians commit suicide every year. When did it get this bad? By the end of this year, it’s estimated that 300 physicians will commit suicide. While depression amongst physicians is not new—a few years back, it was named the second-most suicidal occupation—the level of sheer unhappiness amongst physicians is on the rise. It’s hard for anyone outside the profession to understand just how rotten the job has become—and what bad news that is for America’s health care system. Perhaps that’s why author Malcolm Gladwell recently implied that to...

SALEM, N.H.—New Hampshire's rollout of the Affordable Care Act has been one of the rockiest in the nation, putting Democratic Sen. Jeanne Shaheen on the front lines of Republican efforts to make the 2014 elections a referendum on the health law.Only a single insurer in the state offers policies through the new law. Ten of the state's 26 hospitals and one fifth of its primary care providers aren't in its network. Residents of Concord, the state capital, have to drive to other cities to get covered hospital care.If Ms. Shaheen can weather those conditions, Democrats say it would bode well...